ASSESSMENT OF KNOWLEDGE OF PEPTIC ULCER DISEASE, RISK FACTORS AND MANAGEMENT MODALITIES AMONG STUDENT NURSES OF EDO STATE COLLEGE OF NURSING SCIENCES, BENIN CITY

Abstract

This study investigated the knowledge and awareness of peptic ulcer disease (PUD) among student nurses, focusing on their understanding of risk factors, symptoms, complications, and management strategies. Adopting a quantitative survey research design, a structured questionnaire was distributed to a sample of 133 nursing students to gather data on their knowledge and competency regarding PUD. Descriptive statistics, including frequency tables, percentages, means, and standard deviations, were used to analyze the responses, while a one-sample t-test assessed the significance of the hypotheses. Findings indicated that although most student nurses had a foundational awareness of PUD risk factors, significant gaps existed in their knowledge, particularly concerning symptom identification and complication awareness. Approximately 63% of the participants reported awareness of risk factors, while only 30% felt confident in identifying symptoms. Furthermore, results revealed substantial differences in knowledge levels based on the respondents' year of study and gender, with senior students generally demonstrating higher awareness and comprehension of PUD. The study concluded that while nursing students possess basic PUD knowledge, specific areas require strengthening within nursing curricula. Recommendations included enhancing nursing education with specialized modules on PUD management, symptom recognition, and preventive education, alongside gender-inclusive training programs. This approach aims to equip nursing students with essential skills to educate patients on lifestyle modifications and support public health efforts in reducing PUD incidence. Further research was suggested to evaluate the effectiveness of these educational strategies on clinical outcomes and establish best practices for PUD education in nursing programs.

CHAPTER ONE

INTRODUCTION

1.1 Background to the Study

Peptic ulcer disease (PUD) remains a significant global health issue, impacting millions worldwide and posing substantial challenges to healthcare systems. It primarily affects the gastrointestinal tract, creating open sores in the stomach lining, known as gastric ulcers, or the upper part of the small intestine, known as duodenal ulcers. These ulcers can lead to severe pain, bleeding, and other complications if left untreated, and understanding the underlying causes and risk factors is crucial in managing and preventing this condition. One of the primary contributors to PUD is Helicobacter pylori infection, a widespread bacterium found in nearly half of the global population, although not all carriers develop ulcers (Smith, Fowora, & Pellicano, 2019). The bacterium disrupts the mucosal lining of the stomach and intestines, leading to increased vulnerability to the acid within the digestive tract, which causes the formation of ulcers.

Besides H. pylori infection, nonsteroidal anti-inflammatory drugs (NSAIDs) also play a significant role in the development of PUD. NSAIDs are commonly prescribed for pain relief and inflammation but are known to increase the risk of ulcers when used chronically (Tarasconi et al., 2020). They interfere with the protective mucus lining in the stomach, allowing stomach acid to cause direct harm to the gastrointestinal lining. This adverse effect is particularly concerning for patients with chronic pain conditions who rely on these medications regularly. Health professionals, especially nursing students, must be aware of these risks to provide appropriate guidance to patients on the safe use of NSAIDs.

Lifestyle factors, such as excessive alcohol consumption and smoking, further elevate the risk of developing PUD. Alcohol increases the production of stomach acid and irritates the gastric lining, worsening existing ulcers and contributing to the formation of new ones (Tian et al., 2022). Similarly, smoking not only weakens the stomach lining but also hinders the healing process of existing ulcers, making it difficult for patients to recover fully. Nurses, as patient educators, need to emphasize the importance of lifestyle modifications in PUD prevention to improve patient outcomes.

Given the widespread prevalence of PUD, the World Health Organization (WHO) estimates that nearly 10% of the global population will experience a peptic ulcer at some point in their lives (Shin et al., 2023). This statistic underscores the need for comprehensive preventive strategies, effective treatment approaches, and informed healthcare professionals who can support patients through education and care management. For nursing students, understanding the global burden of PUD and the steps they can take to mitigate it is fundamental to their training and future practice.

Nursing professionals, particularly students preparing to enter the healthcare workforce, have a crucial role in patient education and the management of PUD. By understanding the risk factors, symptoms, and management strategies, nursing students can deliver more effective care and advocate for their patients (Oti et al., 2017). Furthermore, by educating patients on preventive strategies, nursing students can play a pivotal role in reducing the incidence and severity of PUD in the communities they serve.

The clinical manifestations of PUD include burning stomach pain, bloating, nausea, and in severe cases, vomiting blood or experiencing black, tarry stools. These symptoms can significantly impact a patient’s quality of life and may require immediate medical intervention (Wu et al., 2020). Educating patients on recognizing these symptoms early can prevent complications and improve prognosis. Nursing students must be trained to recognize these symptoms promptly, conduct appropriate patient assessments, and refer patients for further evaluation when necessary.

For effective PUD management, student nurses must understand various treatment modalities, including antibiotic regimens for H. pylori eradication, acid-suppressing medications, and lifestyle modifications. The “screen and treat” approach for H. pylori has been effective in certain populations, with studies showing a preference for this method in preventing PUD and related complications (Takeoka et al., 2017). By familiarizing themselves with these treatment strategies, nursing students can offer better support to patients and tailor advice to individual needs.

In addition to pharmacological treatments, lifestyle and dietary adjustments form an integral part of PUD management. Avoiding foods that trigger acid reflux, maintaining a balanced diet, and managing stress are essential for ulcer prevention and healing (Zhang, Lu, & Graham, 2022). Stress, in particular, is known to exacerbate PUD symptoms, which highlights the need for holistic care approaches that address not only physical but also psychological factors affecting patients with PUD. Nursing students must be trained to offer comprehensive, evidence-based guidance that incorporates both medical and lifestyle strategies.

In Nigeria, and particularly in Edo State, gastrointestinal disorders are prevalent, and PUD is a significant concern. Healthcare facilities frequently encounter patients presenting with PUD symptoms, which necessitates a well-trained nursing workforce to address this health issue effectively (Oti et al., 2021). The role of nursing students, therefore, becomes crucial in regions like Edo State, where the burden of PUD and other gastrointestinal issues is high.

The Edo State College of Nursing Sciences in Benin City provides an ideal setting to evaluate the knowledge levels of nursing students regarding PUD. A thorough assessment of their understanding of PUD risk factors, symptoms, and management strategies could reveal potential gaps in knowledge that need to be addressed to improve patient care outcomes. Enhancing nursing education around PUD will better prepare student nurses to manage this condition effectively and offer preventive guidance (Oti et al., 2017).

Furthermore, understanding the impact of H. pylori on gastrointestinal health is essential for nursing students, as the infection remains one of the primary contributors to PUD worldwide. In Africa, the prevalence of H. pylori infections is particularly high, and challenges in healthcare access can complicate early diagnosis and treatment (Smith, Fowora, & Pellicano, 2019). As future healthcare professionals, nursing students need to be equipped with knowledge on diagnosing and treating H. pylori-related PUD to reduce the health impact of this infection.

This study will not only assess the current knowledge level of nursing students in Edo State but also seek to understand the implications of this knowledge (or lack thereof) on patient care. When nursing students are well-informed about PUD and its risk factors, they are more likely to engage patients in discussions about prevention and lifestyle changes, which could contribute to reducing the incidence of PUD (Shin et al., 2023). In this way, student nurses can play a proactive role in combating PUD in their communities.

1.2 Statement of the Problem

Peptic ulcer disease (PUD) remains a prevalent and persistent global health issue, with particularly high prevalence in regions like Africa due to the increased exposure to Helicobacter pylori and limited healthcare resources for preventive and diagnostic measures (Smith, Fowora, & Pellicano, 2019). While various studies have investigated the risk factors and pathogenesis of PUD, significant gaps persist in understanding the depth of knowledge among nursing students, especially regarding PUD management and prevention. For instance, although the role of H. pylori in PUD has been extensively documented, there is limited research on how well student nurses understand this factor and its implications for patient care (Wu et al., 2020). Understanding these knowledge gaps is crucial, as well-informed nursing students can significantly impact patient education and preventive healthcare strategies.

In regions like Edo State, Nigeria, where the burden of gastrointestinal disorders is high, the lack of targeted studies assessing nursing students’ knowledge of PUD presents a substantial gap in healthcare education and practice. Current literature has largely focused on general patient populations or specific risk groups, such as individuals with chronic NSAID use, leaving a significant void in examining healthcare providers' preparedness, particularly among those in training (Tarasconi et al., 2020). This lack of insight into nursing students’ awareness about the risk factors, symptoms, and preventive strategies of PUD creates a barrier to effective healthcare provision, as inadequate knowledge can impede effective patient communication and intervention.

Moreover, while studies have explored lifestyle factors such as smoking and alcohol consumption in PUD development, there is a paucity of research exploring whether nursing students are adequately educated on these lifestyle components and how these may affect patient outcomes (Tian et al., 2022). Addressing this gap is essential, as nurses play a key role in counseling patients on lifestyle modifications, a component proven to be crucial in PUD prevention and management. Additionally, although the “screen and treat” approach for H. pylori has been recommended in several settings, its applicability and the understanding of this approach among nursing students in Edo State remain unexamined (Takeoka et al., 2017).

Ultimately, the absence of studies on nursing students’ knowledge about PUD in high-prevalence regions like Edo State represents a notable research gap. Addressing this gap is essential for developing targeted educational programs that can better equip nursing students with the skills and knowledge needed to address PUD in patient populations effectively. Enhanced understanding among student nurses could lead to improved patient outcomes through preventive education, early diagnosis, and tailored management approaches.Bottom of Form

1.3 Purpose of the Study

The primary purpose of this study is to assess the knowledge of peptic ulcer disease among student nurses at the Edo State College of Nursing Sciences, Benin City. The specific objectives are as follows:

1. To evaluate the level of knowledge of student nurses regarding the causes and risk factors associated with peptic ulcer disease.
2. To assess the understanding of the symptoms and complications of peptic ulcer disease among student nurses.
3. To determine the knowledge of management modalities for peptic ulcer disease among student nurses.

1.4 Research Questions

The study will seek to answer the following research questions:

1. What is the level of knowledge of student nurses regarding the risk factors associated with peptic ulcer disease?
2. How well do student nurses understand the symptoms and complications of peptic ulcer disease?
3. What is the extent of knowledge among student nurses concerning the management modalities for peptic ulcer disease?

1.5 Research Hypotheses

The following hypotheses will guide this study:

1. There is no significant difference in the knowledge of peptic ulcer disease risk factors among student nurses based on their year of study.
2. There is no significant relationship between the level of knowledge of peptic ulcer disease symptoms and the academic performance of student nurses.
3. The knowledge of management modalities for peptic ulcer disease does not significantly differ between male and female student nurses.

1.6 Significance of the Study

This study offers considerable value for a range of stakeholders. For nursing education, it provides crucial insights into the existing knowledge gaps among student nurses, which will enable nursing educators to develop curricula and training programs that specifically target areas where knowledge is lacking. Addressing these deficiencies through targeted education will ensure that nursing students are better prepared to manage peptic ulcer disease (PUD) in clinical settings.

In terms of healthcare delivery, enhancing the understanding of student nurses about PUD is expected to lead to improvements in patient care and disease management practices. Well-informed nursing students can contribute significantly to patient outcomes by applying best practices in PUD management, ensuring that patients receive informed care that addresses both the physical and educational needs associated with the disease. Improved knowledge among student nurses will therefore likely translate to better health outcomes for patients suffering from PUD, as they will benefit from enhanced preventive care, timely interventions, and effective treatment approaches.

For policymakers, the study emphasizes the importance of integrating comprehensive training on gastrointestinal disorders into nursing programs. By highlighting these educational needs, the study can contribute to influencing health policies and raising educational standards within nursing education. This aligns with broader public health goals by promoting a well-informed healthcare workforce that can meet the demands of prevalent health issues such as PUD. As policymakers recognize the need for specialized knowledge in nursing education, they can support curricular changes that improve healthcare delivery across various settings.

Finally, the study serves as a foundation for future research aimed at assessing knowledge levels of healthcare providers in relation to gastrointestinal diseases. By establishing baseline data on the current knowledge among student nurses, this research can guide subsequent studies in examining and comparing the knowledge and competencies of other healthcare providers. This progression in research will further contribute to a better understanding of how knowledge deficits impact patient care and will encourage the development of educational interventions to address these gaps in the healthcare system.

1.7 Scope of the Study

This study will be limited to student nurses enrolled at the Edo State College of Nursing Sciences in Benin City. The focus will be on assessing their knowledge of peptic ulcer disease, including its risk factors, symptoms, and management modalities. The study will not include nursing students from other institutions or healthcare professionals, as it aims to provide a specific assessment relevant to the educational context of the college. The study will be conducted over a period of three months, during which data will be collected through questionnaires.

1.8 Operational Definition of Terms

1. Peptic Ulcer Disease (PUD): A gastrointestinal condition characterized by the formation of open sores in the stomach or duodenum, primarily caused by Helicobacter pylori infection, NSAID use, and lifestyle factors.
2. Student Nurses: Individuals enrolled in a nursing program who are undergoing training to become registered nurses, specifically those at the Edo State College of Nursing Sciences.
3. Risk Factors: Conditions or behaviors that increase the likelihood of developing peptic ulcer disease, including smoking, excessive alcohol consumption, stress, and prolonged use of NSAIDs.
4. Management Modalities: Various treatment strategies employed to manage peptic ulcer disease, including pharmacological therapies (e.g., proton pump inhibitors, antibiotics) and lifestyle modifications.
5. Knowledge Assessment: The process of evaluating the understanding and awareness of student nurses regarding peptic ulcer disease, including its causes, symptoms, and treatment options.
6. Symptoms: Clinical manifestations of peptic ulcer disease, which may include abdominal pain, bloating, indigestion, nausea, and vomiting.
7. Complications: Adverse effects that may arise from untreated peptic ulcer disease, including bleeding, perforation, and gastric obstruction.
8. Curriculum Development: The process of designing and implementing educational programs that enhance the knowledge and skills of nursing students in relation to specific health conditions like peptic ulcer disease.